Radioiodine Treatment - CCDHB

Radioiodine Treatment

Patient Information

Radiology Department ¨C Nuclear Medicine

What is Thyrotoxicosis?

This is a general term for diseases of the thyroid gland

in which the thyroid produces too much thyroid

hormone.

Thyroid hormone is needed for many body processes,

however excess of this hormone means the processes

tend to run too fast. This can produce many symptoms

including rapid heart rate, muscle tremor, bowel upsets,

undue sensitivity to heat and dry, sore eyes. Commonly

the condition results in weight loss and exhaustion.

What are the treatment options?

There are three main options:

? Surgery, where part of or all of the thyroid is

removed

? Drugs that block the effects of the excess hormone

? Treatment with radioiodine

What is radioiodine?

Iodine is found in many foodstuffs and is an essential

part of our diet. The thyroid extracts iodine from the

blood and uses it as raw material to make thyroid

hormones.

Radioiodine is a short lived radioactive form of iodine,

and is chemically the same as dietary iodine. This means

radioiodine is extracted into the thyroid in the same

way, with up to 80% of the radioiodine concentrated in

the thyroid within a few hours.

How does radioiodine work?

Radiation from the radioiodine prevents some of the

thyroid cells from functioning correctly. A fraction of

the cells eventually die off, which reduces the

production of thyroid hormone. This can correct your

Thyrotoxicosis.

Like surgery, radioiodine treatment is a permanent fix.

Unlike surgery it is quick and painless, usually only

requiring a single outpatient visit.

Is radioiodine suitable for me?

Allergies to iodine are not a barrier to treatment. The

amount given is so small, it is not enough to produce an

allergic reaction. If you have had, or currently taking any

CapitalDoc ID: 1.8679 | Issue date: Aug 2015 | Review date: Aug 2018

of the following they may affect your treatment, and

need to be discussed with your doctor:

? Thyroid medication

? Some types of health food, particularly kelp tablets

and some dietary supplements

? Some types of X-ray contrast dyes

? Some types of heart and blood pressure medication

Please bring a list your medication with you when you

come for treatment.

I am or am trying to get pregnant

Can I take radioiodine? If there is any possibility that

you are pregnant it is unlikely that we will give you

radioiodine treatment. This is because the baby¡¯s

thyroid would also receive radioiodine at the same time

as yours. This could affect the baby¡¯s thyroid function.

If your are not sure whether you are pregnant, or are

trying to get pregnant or trying to father a child,

please tell your doctor or a Nuclear Medicine staff

member before treatment.

This therapy does not effect fertility.

In most cases we advise avoiding pregnancy for six

months after radioiodine therapy. Men wishing to

father a child should wait for a period of four

months.

I am breastfeeding. Can I take radioiodine?

Once you have taken radioiodine a small amount will be

present in your breast milk and could affect the

function of your baby¡¯s thyroid. Also, while you are

lactating the breasts will concentrate large amounts of

the iodine. For these reasons you will either have to

defer your treatment, or stop breast feeding for 4-6

weeks before any therapy. You may not resume

breastfeeding for that child. Nursing may be resumed

with the birth of another child.

Does radioiodine have any side-effects?

? The doctor who requested the radioiodine will

arrange for you to have a blood test at a later date

to assess the effectiveness of treatment.

? Your thyroid gland might stop functioning entirely

following treatment. If this is the case it is likely you

may be required to begin taking a tablet call

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?

?

?

Thyroxine on a daily basis to supplement your

hormone level.

You may notice a dry mouth or mildly tender

thyroid for a time after treatment but this will

disappear in a few days.

Thyroid disease can affect your eyes, and

radioiodine treatment has been known to worsen

this effect for a short time. Your doctor may

prescribe drugs to prevent this.

If you already have symptoms from your thyroid

disease these may be worsened for a short period

after treatment. Your doctor may advise some

additional medication during this time.

Are there other risks I need to consider?

The risks of using radioiodine are similar to the risks for

ordinary x-rays. As some of the radiation escapes from

your thyroid, there is a slight risk to people close to you

if you do not take precautions for a few days after

treatment. However the risk is very low. This treatment

has been used for over 50 years, and no measurable illeffects from the radiation have been reported.

The radioactivity clears quite quickly and most has

disappeared in a few days but it takes much longer for it

to have an effect on your thyroid cell numbers.

This is not an instant cure; the process will take many

weeks so you should see a slow but steady

improvement.

We do take particular care to avoid exposing young

children or anyone who is pregnant. This is because

children and babies are more sensitive than adults to

radiation, so we adapt a more cautious approach.

Can I expose other people to radiation after my

treatment?

1. Some of the radiation from the radioiodine shines

from your body-just like x-rays

If you are close to other people they will be exposed to

this radiation. In practical terms, if people are more

than one or two metres away, the intensity is so low

that it can be ignored.

2. Your thyroid uses only part of the radioiodine, the

rest is eliminated from your body

Most of the excess radioiodine is eliminated in the first

few days through your urine and a very small amount is

eliminated through sweating and nasal secretions.

CapitalDoc ID: 1.8679 | Issue date: July 2015 | Review date: July 2018

The radiation dies away naturally so while you may

need to take some precautions to avoid exposing

others, this is usually only for a few days after

treatment

What precautions do I need to take following

radioiodine treatment?

As everyone is different, the precautions you need to

take should fit your circumstances. These will be

discussed with you before your treatment however

there are some general things you need to consider.

Time away from work

You may need to take a few days off work after the

treatment. It is difficult to say exactly how long since it

depends on the nature of your work and the amount of

radioiodine your doctor has prescribed for you, but

most people will need somewhere between three and

six days off work. This time can be reduced if you work

on your own.

Our usual day for administering radioiodine therapies is

Thursday afternoon, so for most cases you will be able

to return to work on the following Monday or

Wednesday.

Care of Children

If you are taking care of very young children at home, or

someone in your household is pregnant then you may

need to make arrangements to reduce their exposure to

radiation. If this applies to you please discuss this with

your doctor prior to your treatment.

Sleeping Arrangements

You should sleep apart from partners (e.g. sleep in a

spare room or on a temporary bed) to minimize the

amount of radiation they receive. This can be from 2 to

7 days after treatment, depending on the amount of

radioiodine that has been prescribed for you. Avoid

children sleeping in your bed.

Attending public functions

You should not be attending any public meetings, going

to movies or shows or taking long (more than five

hours) trips on public transport for a few days after

treatment since you could find yourself close to others

for a long time.

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[continued]

Shopping

You will be able to go shopping and make short trips on

public transport since these will not involve extended

periods close to others.

Pets

There are no risks to pets from the radioiodine, so you

do not need to make special arrangements for their

care.

Food and drink

We would advise you to drink a little more fluid than

usual for the first two days after treatment. This helps

to clear any excess radioiodine from your body. Other

than this you can eat and drink normally after

treatment, and alcohol will not affect your treatment

Hygiene

A small amount of radioiodine comes out in your

perspiration and nasal secretions over the first few days

after treatment. Some will get on your clothes

(particularly underclothes), sheets, towels and

handkerchiefs.

To eliminate any possible risk to others for the first

three days after treatment:

? Make sure no-one else uses your towels and

wash your towels, sheets, underclothes and

handkerchiefs separately from other laundry

? Do not handle food that other people may be

eating

? Do not share cutlery and dishes with other

people

Toilet arrangements

Any radioiodine not used by your thyroid is cleared by

your kidneys as body waste. This means your urine is

slightly radioactive for two to three days after your

treatment. You will not notice this, but it can be a

potential risk to others.

Ensure that any urine spills are promptly wiped up,

men should urinate sitting down to minimise possible

spills or splashing. After using the toilet, flush at least

twice. If there are urine spills, clean up with toilet

paper and dispose of this in the toilet, then wash your

hands.

Existing health problems

If you have other health problems, particularly

problems with urinary incontinence, or suffer from

frequent nausea and vomiting please discuss this with

your doctor. We may need to make some special

arrangements for your treatment

What happens afterwards?

You will be sent an appointment to have a blood test

about four weeks after treatment, and an appointment

to see the endocrine doctor. If you do not receive these

please contact the appropriate endocrine unit.

Sometimes your doctor will prescribe further treatment

to bring your thyroid fully under control. In this case

you may be need a further dose of radioiodine

In the long term your thyroid may become under-active

after treatment. This will make you feel rather sluggish

and sleepy. If this does happen your doctor will

probably advise taking additional thyroid hormone in

tablet form to top up your level.

Who do I contact for more information?

The best source of information is your own doctor.

If you need additional advice you may contact:

Wellington Endocrine Unit on 04 806 2140

or

Hutt Endocrine Unit on 04 566 6999 extension 8299

Contact us

Phone: (04) 806 2193

Hours: 8am-4pm, Monday to Friday

Email: radiology.admin@.nz

Email: radiology.admin@.nz

CapitalDoc ID: 1.8679 | Issue date: July 2015 | Review date: July 2018

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